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Who Needs Medicare Part B Insurance?

Over the past several years, I have received endless questions about Medicare; but, probably, the most-asked question deals with Medicare Part B Insurance—more specifically: Do I need to enroll in Part B? The correct answer to this question—for you—is absolutely critical. For, if you don’t have the proper understanding to this query, it cost you a lot of money in penalties, premiums, and out-of-pocket costs. So, I applaud you for exploring the answer to this issue.

What Is Medicare Part B Insurance?

First of all, what is Medicare Part B Insurance? Part B (medical insurance) is part of Original Medicare and covers services and supplies that are medically necessary to treat one’s health conditions. This can include doctor charges (not only doctor office visits, but also doctor charges while an inpatient in the hospital), general outpatient care, preventive services, ambulance services, and durable medical equipment. (For more on how Part B covers medical costs, see the post “How Does Medicare Work?”)

While Medicare Part A has no premium for those who qualify for Medicare (U.S. citizens or legal residents who have resided in the U.S. for a minimum of five years and who have worked at least ten years in Medicare-covered employment), Part B has a premium of $174.70 for those entering Medicare in 2024. So, does everyone need to enroll in Medicare Part B Insurance?

Does Everyone Need to Enroll in Medicare Part B?

For most people turning 65, the answer is yes or face a late enrollment penalty. (The Medicare enrollment period includes three months prior to the month you turn 65, the month of, and three months following the month you turn 65.) This monthly penalty will continue as long as you have Medicare.

But for some, the answer is no. If you or your spouse (or family member if you’re disabled) are still working and you have insurance through that employer or union that does not work in conjunction with Medicare, you will likely not need to enroll in Medicare Part B Insurance. (This includes federal or state employment, but not military service (unless on active duty).) In this case, it may be to your advantage to delay Part B enrollment, as you will not need to pay the monthly Part B premium while covered on that company plan.

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However, if your company coverage mandates that you enroll on Medicare Part B (as, in that case, your company insurance works in conjunction with Medicare coverage), it may be to your advantage to look at individual supplemental coverage—especially if you are not carrying a younger spouse on your coverage. If you will need to pay for the Part B premium on your company coverage, you may find that you can get better coverage for less money with an individual Medicare supplement.

To Discover What Insurance Coverage Is Best for You . . .

To find out what will be the best for you, make an appointment with an independent insurance agent / consultant who represents multiple companies (one who can shop for you). Certainly, a no-obligation meeting with an independent consultant will be worth finding out what will be your best option, as it could, potentially, save you a lot of money down the road.

John Claeys

John Claeys is the Founder of Claeys Group Insurance Services, as well as a frequent contributor to the Medicare Blog. John lives with his wife of 30 years in Tyler, Texas. Unsure about Medicare coverage options in East Texas? Contact John for guidance and help navigating the Medicare coverage process.

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John Claeys

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